Two area water suppliers are adding a powerful cavity-fighting agent to your cup — or dosing it with a cancer-inducing neurotoxin.

It depends on whom you ask.

Water fluoridation has been a controversial topic for decades. Though strongly advocated as a public service by the mainstream dental community, it is opposed by some scientists and others who believe it does more harm than good.

And given the growing body of conflicting studies on both sides, it doesn’t appear that these differences will be resolved anytime soon.

Somerset County Water System Manager Chris Meyer said there is no doubt that when it comes to fluoride, there are two distinct philosophical camps.

“It is totally opinionated,” he said.

Most Somerset County water suppliers do not fluoridate — with the exception of Somerset Borough and the Greater Johnstown Water Authority, which sells to residents some residents in Conemaugh Township.

‘Effective and . . . safe’

The American Dental Association supports the fluoridation of public water supplies and has, in fact, lobbied to make this additive mandatory in states including Pennsylvania.

“That has not come to fruition yet,” said Rob Pugliese, communication director for the Pennsylvania Dental Association.

“We have the same belief as the ADA,” he added. “All the organizations — the ADA, the PDA — all support water fluoridation. That’s the same stance we’ve had forever.”

The reason, he said, comes down to results. He cited statistics from the Journal of Dental Research showing that those who lived most of their lives in fluoridated water communities had up to 30 percent less tooth decay than those who spent most of their lives in non-fluoridated areas.

According to Pugliese, it’s also cheap: A year’s worth of fluoride normally costs somewhere between 50 cents and $3 per water customer.

“It doesn’t cost a lot, comparatively,” he said.

“It really helps everyone regardless of socioeconomic condition,” he added. “We really look at fluoride as an access-to-care issue. You’re always looking to give people the best care they can get.”

Pugliese acknowledged, however, that high doses of fluoride can be dangerous.

“You have to have it in the right amount,” he said.

Dr. Martin Hogan — director of the dental general practice residency program at Loyola University’s Oral Health Center — stressed that fluoride is a naturally occurring mineral in some foods and water.

Hogan said it is useful because it hardens and remineralizes tooth enamel.

“Most people get enough from the drinking water that they don’t need supplementation,” he said.

Asked if there are any downsides, Hogan noted that overexposure will cause dental fluorosis — spotty discoloration of the teeth.

“It’s not a problem,” he said. “It’s not a disease, it’s just a cosmetic thing.”

Hogan added that ingesting high concentrations of fluoride will cause nausea, which is why toddlers aren’t given fluoride treatments at their dental appointments.

“We usually typically don’t start that until the age of 5,” he said. “Usually younger kids under the age of 5 want to swallow it.”

According to Hogan, the fluoride in public water supplies is diluted to a harmless amount.

‘Differences of opinion’

Mike Kukura has been with the Greater Johnstown Water Authority in various capacities since 1990, shortly after the entity began fluoridating its supply. As resident manager of the authority, he said he feels comfortable that the research is on the pro-fluoridation side.

According to Kukura, putting fluoride into a municipal water supply is a true science. He said regular testing is done to keep the ratio below 0.7 milligrams per liter and the pH at an acceptable level.

“Fluoride’s an acid,” he said. “So you have to add lime to counteract those acidic properties.”

Kukura said he has never received negative feedback or resistance from local customers about fluoridation.

Edward Schmitt of Gibson-Thomas Engineering — who serves as consulting engineer for the Greater Johnstown Water Authority — said he has worked with some clients who want fluoride and some who do not.

“There’s a lot of different philosophies on it,” he said. “It really is a regional consideration. It’s one of those things you can argue until the cows come home.”

A majority of the U.S. population receives fluoridated water because most major cities add the substance to public water supplies. It far less common among small municipal suppliers.

Somerset Borough has a long-standing tradition of fluoridating its water supply. According to borough records, council members unanimously authorized the purchase of fluoridation equipment for the water treatment plant on March 8, 1957.

Borough Manager Benedict G. Vinzani Jr. said this practice began long before he was ever involved with local government. Last year the borough purchased 140 50-pound bags of fluoride at a cost of $39.80 each — a total bill of $5,572.

“It’s just something that we’re used to paying for,” he said. “Whoever is the lowest bidder who meets the specifications gets the (contract).”

Vinzani, too, said he hasn’t heard any public resistance to the practice. He offered few personal comments about it.

“As far as fluoridation of a public water supply being a good or bad idea . . . there may certainly be differences of opinion,” he said.

The Somerset County General Authority does not use fluoride. This entity sells water to Somerset Borough, Somerset Township, Conemaugh Township, Lincoln Township and Boswell Borough via the Quemahoning pipeline.

Consulting engineer Jon Wahl of Somerset Planning & Engineering Services said it was simply easier for them to leave it out of the supply.

“The Que system is a provider to multiple municipalities,” he said. “Once you put it in the water you can’t take it out.”

According to Wahl, he and others involved with the water system didn’t sense any real appetite for widespread fluoridation.

“We just never really pursued it,” he said. “Very early on we found that there wasn’t any interest in it.”

‘Corrosive, reactive and toxic’

The anti-fluoride crowd can come across as more sensational than sensible.

But a 2012 study by the Harvard School of Public Health and China Medical University in Shenyang does nothing to dismiss their concerns about prolonged exposure to the additive, even in small doses.

According to the study, “children in high-fluoride areas had significantly lower IQ scores than those who lived in low-fluoride areas. The children studied were up to 14 years of age, but the investigators speculate that any toxic effect on brain development may have happened earlier, and that the brain may not be fully capable of compensating for the toxicity.”

“Fluoride seems to fit in with lead, mercury, and other poisons that cause chemical brain drain,” senior author and Harvard adjunct professor Philippe Grandjean wrote. “The effect of each toxicant may seem small, but the combined damage on a population scale can be serious, especially because the brain power of the next generation is crucial to all of us.”

These kinds of reports also fit in with the opinion of anti-fluoridation folks like Bill Hirzy.

Hirzy had no problem with water fluoridation until he joined the Environmental Protection Agency in the early 1980s after 19 years with the Monsanto Co., a multinational agricultural biotechnology corporation headquartered in Creve Coeur, Mo.

“Up until then, like most Americans, I thought fluoride was just fine,” he said.

But Hirzy said he and a few colleagues came to believe that a pro-fluoride technical support document filed by private contractors was flawed, exaggerating the benefits and downplaying the potential hazards.

“(We became) aware of political pressure to get it at a level that is not protecting the public health,” he said. “From that point on we went through a lot of angst.”

According to Hirzy, the U.S. District Court in Washington, D.C., would not docket an amicus brief that questioned the safety of fluoride. They were given the explanation that this filing would have been akin to the EPA suing itself.

He left the EPA in 2008.

“The reason we have fought the (fluoride movement) is because when we took the oath as civil servants we swore to defend the U.S. Constitution from all enemies, foreign and domestic,” he said, going on to complete the entire oath.

“We felt then, and still feel, that we are defending the Constitution. We didn’t have a dog in the fight about fluoride one way or another.”

Hirzy — a professor at American University who holds a Ph.D. in chemistry from the University of Missouri — can sound off for hours on the history of fluoridation, a nationwide practice that has its roots right here in western Pennsylvania.

The first fluoridation proposal in America, he said, came to Johnstown City Council in the late 1930s on behalf of the Andrew W. Mellon-founded Alcoa Corp.

“And everyone pretty much said, ‘No, thank you, we’re not going to do that,’” he said.

For much of his background, Hirzy cites “The Fluoride Deception,” a book and documentary by former BBC producer Christopher Bryson. This work alleges that Alcoa was trying to get rid of fluoride because it was a byproduct of the company’s aluminum production facilities.

According to Hirzy, fluoride was also produced by contractors working on the atomic bomb for the Manhattan Project in the 1940s.

Hirzy said toxicologist Harold Hodge of the Atomic Energy Commission was charged with studying fluoride for potential benefits. Hodge’s report concluded that fluoride was good for developing teeth and was relatively harmless to ingest.

But Hirzy is quick to point out that Hodge’s reputation has been tarnished since the publication of Eileen Welsome’s book “The Plutonium Files.” Her work details secret uranium and plutonium tests that Hodge and other federally funded scientists conducted on fellow human beings.

Welsome was awarded a Pulitzer Prize for a newspaper series on this topic, which was published in The Albuquerque Tribune in the 1990s.

According to the Centers for Disease Control and Prevention website, “the three fluoride additives used for water fluoridation are derived principally from phosphate fertilizer production.”

“This is pure profit for the phosphate people,” Hirzy said. “It would qualify as a hazardous waste. It’s corrosive, reactive and toxic.”

He said the phosphate industry is able to make a profit on fluoride instead of disposing of it at a cost of approximately $1.40 per gallon.

“They change all that red ink into black ink,” he added. “They have a great economic interest.”

According to Hirzy, some studies indicate that fluoride is only effective when used in a “topical” manner — applying to the surface only. Hirzy likened drinking fluoride for enamel protection to drinking sunscreen for skin protection.

His goal, he said, is to have it banned from municipal water systems as a matter of public safety.

“I’m trying to get some interest in Congress. There’s a lot of information that indicates putting this stuff in drinking water doesn’t work.”